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A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy

BACKGROUND AND OBJECTIVES: Laparoscopic sleeve gastrectomy is gaining popularity as a bariatric procedure, with outcomes similar to gastric band and gastric bypass. Staple-line disruption is a significant source of morbidity and death. We aim to evaluate the effect of staple-line reinforcement on th...

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Autores principales: Knapps, Jean, Ghanem, Maher, Clements, John, Merchant, Aziz M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771757/
https://www.ncbi.nlm.nih.gov/pubmed/24018075
http://dx.doi.org/10.4293/108680813X13654754534639
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author Knapps, Jean
Ghanem, Maher
Clements, John
Merchant, Aziz M.
author_facet Knapps, Jean
Ghanem, Maher
Clements, John
Merchant, Aziz M.
author_sort Knapps, Jean
collection PubMed
description BACKGROUND AND OBJECTIVES: Laparoscopic sleeve gastrectomy is gaining popularity as a bariatric procedure, with outcomes similar to gastric band and gastric bypass. Staple-line disruption is a significant source of morbidity and death. We aim to evaluate the effect of staple-line reinforcement on the gastric leak rate, morbidity, and mortality rate. METHODS: A systematic review was performed using title key words “sleeve gastrectomy,” and articles were reviewed for description of operative technique and postoperative outcomes including staple-line leak. Rates of leak, bleeding, surgical-site infection, reintervention, readmission, and mortality were analyzed. We calculated pooled event rates and 95% confidence intervals using fixed-effects modeling to determine differences between the reinforcement group (group A) and non-reinforcement group (group B). RESULTS: We identified 390 articles, and 30 met the inclusion criteria. Group A had 3293 patients, and group B had 1588 patients. After heterogeneity calculations, 9 variables met the criteria to be analyzed. The leak rate was 3.9% (95% confidence interval, 2.9%–5.5%) in group A and 3.2% (95% confidence interval, 2.8%–4.1%) in group B. The mortality rate was 0.8% (95% confidence interval, 0.4%–1.5%) in group A and 0.7% (95% confidence interval, 0.4%–1.1%) in group B. Our results also showed no statistical difference for any of our other 7 outcome variables. CONCLUSION: Our study shows a lack of statistical difference in leak rate, overall morbidity, or mortality rate in laparoscopic sleeve gastrectomy with or without staple-line reinforcement. Because of study limitations, we propose that prospective trials are needed to determine the effect of staple-line reinforcement on leak rates.
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spelling pubmed-37717572013-09-16 A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy Knapps, Jean Ghanem, Maher Clements, John Merchant, Aziz M. JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Laparoscopic sleeve gastrectomy is gaining popularity as a bariatric procedure, with outcomes similar to gastric band and gastric bypass. Staple-line disruption is a significant source of morbidity and death. We aim to evaluate the effect of staple-line reinforcement on the gastric leak rate, morbidity, and mortality rate. METHODS: A systematic review was performed using title key words “sleeve gastrectomy,” and articles were reviewed for description of operative technique and postoperative outcomes including staple-line leak. Rates of leak, bleeding, surgical-site infection, reintervention, readmission, and mortality were analyzed. We calculated pooled event rates and 95% confidence intervals using fixed-effects modeling to determine differences between the reinforcement group (group A) and non-reinforcement group (group B). RESULTS: We identified 390 articles, and 30 met the inclusion criteria. Group A had 3293 patients, and group B had 1588 patients. After heterogeneity calculations, 9 variables met the criteria to be analyzed. The leak rate was 3.9% (95% confidence interval, 2.9%–5.5%) in group A and 3.2% (95% confidence interval, 2.8%–4.1%) in group B. The mortality rate was 0.8% (95% confidence interval, 0.4%–1.5%) in group A and 0.7% (95% confidence interval, 0.4%–1.1%) in group B. Our results also showed no statistical difference for any of our other 7 outcome variables. CONCLUSION: Our study shows a lack of statistical difference in leak rate, overall morbidity, or mortality rate in laparoscopic sleeve gastrectomy with or without staple-line reinforcement. Because of study limitations, we propose that prospective trials are needed to determine the effect of staple-line reinforcement on leak rates. Society of Laparoendoscopic Surgeons 2013 /pmc/articles/PMC3771757/ /pubmed/24018075 http://dx.doi.org/10.4293/108680813X13654754534639 Text en © 2013 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Knapps, Jean
Ghanem, Maher
Clements, John
Merchant, Aziz M.
A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy
title A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy
title_full A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy
title_fullStr A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy
title_full_unstemmed A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy
title_short A Systematic Review of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy
title_sort systematic review of staple-line reinforcement in laparoscopic sleeve gastrectomy
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771757/
https://www.ncbi.nlm.nih.gov/pubmed/24018075
http://dx.doi.org/10.4293/108680813X13654754534639
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